MRI and ultrasonography for detection of early interphalangeal osteoarthritis

ObjectivesTo assess the interest of MRI and ultrasonography (US) in identifying early and advanced interphalangeal (IP) OA.MethodsWe conducted a case-control study including patients with symptomatic hand OA (n = 33) and young healthy volunteers (n = 26). Proximal and distal IP joints were graded according to Kellgren and Lawrence (KL) grades. In OA patients, we separated IP joints into 2 groups: “at risk of OA” joints (potential early pre-radiographic OA joints, KL = 0) and OA joints (KL = 2–4). All IP joints from healthy participants were KL = 0 and were considered strictly normal IP joints. Concurrently, synovitis, effusion, erosions, osteophytes, bone marrow lesions, cysts and cartilage space loss were graded by MRI and/or US. We assessed their prevalence, severity and diagnostic performance in hand OA and then compared normal IP joints from healthy participants and “at risk of OA” IP joints from OA patients as well as “at risk of OA” and OA IP joints from OA patients.ResultsThe prevalence and grade of most MRI/US-detected lesions were higher in IP joints from OA patients than healthy participants. Except for osteophyte assessment, MRI seemed more sensitive than US. We found more MRI/US-detected lesions in “at risk of OA” IP joints than normal joints but also in OA than “at risk of OA” joints from OA patients. US appeared both sensitive and specific for detecting osteophytes in joints without radiographic abnormalities.ConclusionsMRI and US give good performance for detecting radiographic and pre-radiographic OA lesions and could be interesting tools to identify early hand OA.     

清热解毒方联合封闭负压引流治疗手外伤感染临床研究

目的 评价清热解毒方联合封闭负压引流治疗手外伤感染的疗效.方法 将符合纳入标准的108例手外伤创面感染患者采用随机数字表法分为2组,每组54例.对照组采用封闭负压引流治疗,观察组在对照组基础上加用清热解毒方.2组均治疗14d.分别于治疗前后对创面分泌物与肉芽组织进行评分,采用ELISA法检测血清IL-6含量,采用免疫量度法检测血清TNF-α含量,记录患者治疗后创面愈合情况及愈合时间.结果 治疗后,观察组分泌物评分[(1.6±0.4)分比(2.2±0.4)分,t=4.659]、肉芽组织评分[(1.7±0.2)分比(2.2±0.3)分,t=4.541]均低于对照组(P<0.01);血清IL-6[(64.89±2.31)μg/L比(72.18±3.02)μg/L,t=9.562]、TNF-α[(318.67±15.21)μg/L比(397.49±17.63)μg/L,t=15.611]水平均低于对照组(P<0.01);观察组创面愈合率为96.3%(52/54)、对照组为55.6%(30/54),2组比较差异有统计学意义(χ2=24.518,P<0.001);观察组创面愈合时间[(15.2±3.0)d比(25.2±4.7)d,t=11.551]较对照组缩短(P<0.01).结论 清热解毒方联合封闭负压引流可有效促进手外伤感染患者创面修复及愈合,降低炎性细胞因子水平.     

基于红外光谱法的云南重楼及其近缘种的亲缘关系研究

目的傅里叶变换红外光谱(fourier transform infrared spectroscopy,FTIR)结合化学计量学方法分析云南重楼Paris polyphylla var.yunnanensis及其近缘种的亲缘关系,为重楼属药用植物资源的开发利用提供理论依据。方法采集云南重楼、白花重楼Paris polyphylla var.alba、毛重楼Paris mairei、南重楼Paris vietnamensis、五指莲Paris axialis var.axialis共50份样品的红外光谱信息,对光谱数据进行自动基线校正、自动平滑、纵坐标归一化、多元散射校正、二阶求导等预处理,采用主成分分析(principal component analysis,PCA)、偏最小二乘判别分析(partial least squares discriminant analysis,PLS-DA)及系统聚类分析(hierarchical cluster analysis,HCA)分析光谱数据。结果原始红外光谱中,1 653、1 156、1 082、1 021、925、851、759、572、524 cm~(-1)等为重楼属植物的共有峰,主要归属为黄酮、淀粉和糖苷类成分的吸收峰;毛重楼和五指莲分别在1 535和1 369 cm~(-1)附近有特征吸收峰,可与另外3种重楼属植物相区分。以全波段光谱数据进行PLS-DA和PCA,PLS-DA对重楼属植物分类效果优于PCA,能够准确区分5种野生重楼属植物。系统聚类分析(HCA)及向量夹角余弦相关性分析能够反映5个重楼属植物的亲缘关系,云南重楼与白花重楼和南重楼的亲缘关系较近,与毛重楼和五指莲的关系较远。结论 FTIR结合化学计量学方法,能够快速区分不同种类重楼属植物,明确云南重楼及其近缘种之间的亲缘关系,为重楼属植物亲缘关系研究提供一种快速、有效的方法,同时为重楼种质资源开发和利用提供理论基础。